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Of interest to psychiatrists is Lacis' work as a children's theatre director. Pioneer female theatre director Asja Lacis was born in the Russian Empire's Livonia (Latvia) and gained a degree from neurologist and experimental psychologist Vladimir Bekhterev's (1857-1927) Institute of Psychoneurology in St Petersburg. Daughter Daga's ill health took Lacis to Capri in 1924, where she had an affair with German critic Walter Benjamin (1892-1940). [Extracted from the article]

Some studies have indicated that oestrogen therapy may be beneficial in the treatment of a number of neuropsychiatric disorders. However, it has been suggested that psychiatrists fail to prescribe oestrogen therapy to their patients, as they are 'not aware of' or 'do not believe' studies supporting their use. This paper reappraises the putative role of hormone treatments, particularly oestrogen therapy, in psychiatry. [ABSTRACT FROM AUTHOR]

Background: Symptoms of obsessive-compulsive disorder (OCD) have been described in neuropsychiatric syndromes associated with streptococcal infections. It is proposed that antibodies raised against streptococcal proteins cross-react with neuronal proteins (antigens) in the brain, particularly in the basal ganglia, which is a brain region implicated in OCD pathogenesis.Aims: To test the hypothesis that post-streptococcal autoimmunity, directed against neuronal antigens, may contribute to the pathogenesis of OCD in adults.Method: Ninety-six participants with OCD were tested for the presence of anti-streptolysin-O titres (ASOT) and the presence of anti-basal ganglia antibodies (ABGA) in a cross-sectional study. The ABGA were tested for with western blots using three recombinant antigens; aldolase C, enolase and pyruvate kinase. The findings were compared with those in a control group of individuals with depression (n = 33) and schizophrenia (n = 17).Results: Positivity for ABGA was observed in 19/96 (19.8%) participants with OCD compared with 2/50 (4%) of controls (Fisher's exact test P = 0.012). The majority of positive OCD sera (13/19) had antibodies against the enolase antigen. No clinical variables were associated with ABGA positivity. Positivity for ASOT was not associated with ABGA positivity nor found at an increased incidence in participants with OCD compared with controls.Conclusions: These findings support the hypothesis that central nervous system autoimmunity may have an aetiological role in some adults with OCD. Further study is required to examine whether the antibodies concerned are pathogenic and whether exposure to streptococcal infection in vulnerable individuals is a risk factor for the development of OCD. [ABSTRACT FROM AUTHOR]

Background: Evidence suggests a role for oestrogen in depression but the involvement of oestrogen receptor polymorphisms remains unknown.Aims: To determine the association between oestrogen receptor polymorphisms and late-life depression and the modifying effect of hormone treatment.Method: Depression was assessed using the Mini-International Neuropsychiatric Interview, according to DSM-IV criteria and the Centre for Epidemiologic Studies - Depression Scale. The association between oestrogen receptor α and β (ER-α and ER-β) polymorphisms with severe depression was examined in 6017 community-dwelling elderly people using multivariate logistic regression.Results: In women, the ER-α rs2234693 and rs9340799 polymorphisms were significantly associated with the risk of late-life depression. The A allele of ER-β rs1256049 increased the risk of depression, but only for non-current users of hormone treatment. In men, only the ER-β rs4986938 polymorphism showed a weak association with depression risk.Conclusions: Oestrogen receptor polymorphisms are associated with severe late-life depression risk in women only. [ABSTRACT FROM AUTHOR]

Background: To promote clinical application of the Schedules for Clinical Assessment in Neuropsychiatry (SCAN) system a shorter version (the mini-SCAN) was devised. Its psychometric properties were unknown.Aims: To establish the validity and practical properties of the mini-SCAN.Method: One hundred and six participants were interviewed twice, once with the SCAN and once with the mini-SCAN. The level of agreement was established for the categories: no disorder, affective disorders, anxiety disorders, non-affective psychotic disorders, affective psychotic disorders.Results: The mini-SCAN is a valid instrument. Most kappa values were around 0.90. Only for the class of affective psychotic disorders was the agreement moderate. Mean duration of the mini-SCAN interviews was 25 min shorter than the SCAN interviews. Participants and interviewers were generally satisfied with the interview format and questions.Conclusions: The mini-SCAN can be used as a diagnostic instrument for clinical purposes and for clinical studies when the present episode is the focus of attention. [ABSTRACT FROM AUTHOR]

Background: Well-tolerated and effective therapies for bipolar mania are required.Aims: To evaluate the efficacy and tolerability of aripiprazole as acute and maintenance of effect therapy in patients with bipolar I disorder experiencing manic or mixed episodes.Method: Patients were randomised to double-blind aripiprazole (15 or 30 mg/day; n=167), placebo (n=153) or haloperidol (5-15 mg/day, n=165) for 3 weeks (trial registration NCT00097266). Aripiprazole- and haloperidol-treated patients remained on masked treatment for 9 additional weeks.Results: Mean change in Young Mania Rating Scale Total score (primary end-point) at week 3 was significantly greater with aripiprazole (-12.0; P<0.05) and haloperidol (-12.8; P<0.01) than with placebo (-9.7). Improvements were maintained to week 12 for aripiprazole (-17.2) and haloperidol (-17.8). Aripiprazole was well tolerated. Extrapyramidal adverse events were more frequent with haloperidol than aripiprazole (53.3% v. 23.5%).Conclusions: Clinical improvements with aripiprazole were sustained to week 12. Aripiprazole was generally well tolerated. [ABSTRACT FROM AUTHOR]

Background: Alexithymia has been shown to be related to many psychiatric and somatic illnesses. Aberrant emotion processing in the brain may underlie several psychiatric disorders. However, little is known about the neurobiological underpinnings of alexithymia.Aims: To determine the way in which the brain processes emotion in alexithymia.Method: The participants were 10 healthy women with alexithymia and 11 healthy women without this condition, recruited into the study on the basis of their scores on the 20-item Toronto Alexithymia Scale. Four films were projected on a video screen to induce each of three emotional conditions (neutral, amusement, sadness). The brain areas activated during emotional stimuli in the alexithymia group were compared with those activated in the non-alexithymia group. Scans of the distribution of [(15)O]H(2)O were acquired using a positron emission tomography (PET) scanner operated in three-dimensional mode.Results: In response to emotional stimuli participants with alexithymia activated more parts of their sensory and motor cortices and insula, especially on the left side, and less of their anterior cingulate, compared with the control group.Conclusions: Women with alexithymia seem to over-activate their 'bodily' brain regions, implying a different mode of emotion processing. This may be related to their tendency to experience physical symptoms. [ABSTRACT FROM AUTHOR]

Background: Obsessive-compulsive disorder (OCD) may be related to a dysfunction in frontostriatal pathways mediating inhibitory control. However, no functional magnetic resonance imaging (fMRI) study has tested this in children.Aims: To test whether adolescents with OCD in partial remission would show abnormal frontostriatal brain activation during tasks of inhibition.Method: Event-related fMRI was used to compare brain activation in 10 adolescent boys with OCD with that of 9 matched controls during three different tasks of inhibitory control.Results: During a 'stop' task, participants with OCD showed reduced activation in right orbitofrontal cortex, thalamus and basal ganglia; inhibition failure elicited mesial frontal underactivation. Task switching and interference inhibition were associated with attenuated activation in frontal, temporoparietal and cerebellar regions.Conclusions: These preliminary findings support the hypothesis that paediatric OCD is characterised by a dysregulation of frontostriatothalamic brain regions necessary for motor inhibition, and also demonstrate dysfunction of temporoparietal and frontocerebellar attention networks during more cognitive forms of inhibition. [ABSTRACT FROM AUTHOR]

Background: Abnormalities of cognitive style in bipolar disorder are of both clinical and theoretical importance.Aims: To compare cognitive style in people with affective disorders and in healthy controls.Method: Self-rated questionnaires were administered to 118 individuals with bipolar I disorder, 265 with unipolar major recurrent depression and 268 healthy controls. Those with affective disorder were also interviewed using the Schedules for Clinical Assessment in Neuropsychiatry and case notes were reviewed.Results: Those with bipolar disorder and those with unipolar depression demonstrated different patterns of cognitive style from controls; negative self-esteem best discriminated between those with affective disorders and controls; measures of cognitive style were substantially affected by current levels of depressive symptomatology; patterns of cognitive style were similar in bipolar and unipolar disorder when current mental state was taken into account.Conclusions: Those with affective disorder significantly differed from controls on measures of cognitive style but there were no differences between unipolar and bipolar disorders when current mental state was taken into account. [ABSTRACT FROM AUTHOR]

Background: Reliable, valid and easily administered screening instruments would greatly facilitate large-scale neuropsychiatric research.Aims: To test a parent telephone interview focused on autism - tics, attention-deficit hyperactivity disorder (ADHD) and other comorbidities (A-TAC).Method: Parents of 84 children in contact with a child neuropsychiatric clinic and 27 control children were interviewed. Validity and interrater and test - retest reliability were assessed.Results: Interrater and test - retest reliability were very good. Areas under receiver operating characteristics curves between interview scores and clinical diagnoses were around 0.90 for ADHD and autistic spectrum disorders, and above 0.70 for tics, learning disorders and developmental coordination disorder. Using optimal cut-off scores for autistic spectrum disorder and ADHD, good to excellent kappa levels for interviews and clinical diagnoses were noted.Conclusions: The A-TAC appears to be a reliable and valid instrument for identifying autistic spectrum disorder, ADHD, tics, learning disorders and developmental coordination disorder. [ABSTRACT FROM AUTHOR]

Background: Trends in health treatments and outcomes in the general population may be used to monitor achievement of health targets.Aims: To investigate changes in mental health services and treatment in Britain over a 7-year period.Method: National surveys of psychiatric morbidity were completed in 1993 and 2000 in households throughout Great Britain. Standardised interviews were used to establish psychiatric case status and service and treatment utilisation in adults aged 16-64 years.Results: Use of psychotropic medication doubled in those designated as psychiatric cases. In the non-case-status population antidepressant use rose from 0.16% in 1993 (95% CI 0.07-0.25) to 2.02% in 2000 (95% CI 1.69-2.35). However, the overall prevalence of neurotic and psychotic disorder hardly changed from 1993 to 2000. Use of specialised 'talking treatments'did not increase significantly, except in the non-case group.Conclusions: Treatment with psychotropic medication alone is unlikely to improve the overall mental health of the nation. A policy based almost exclusively on treatment of identified cases should be augmented by preventive approaches. [ABSTRACT FROM AUTHOR]

Background Certain personality traits may mediate the relationship between familiality and adversity in causing depression. Aims To examine whether the neuroticism and extraversion scales of the Eysenck Personality Inventory (EPI) represent enduring traits underlying the vulnerability to respond to adversity by developing depressive episodes. Method A total of 108 subjects with depression and their siblings were compared with 105 healthy control subjects and their siblings. All were interviewed using the Schedules for the Clinical Assessment of Neuropsychiatry and the Life Events and Difficulties Schedule. Subjects also completed the EPI. Results Both neuroticism and extraversion were familial and correlated with mood and life event measures. There were no differences on either measure between the never-depressed siblings of probands with depression and controls. Regression analyses showed that the major influence on neuroticism was current mood. Conclusions Neither extraversion nor neuroticism measures trait vulnerability to depression, and neuroticism scores mainly reflect symptoms of depression. [ABSTRACT FROM AUTHOR]

Background: This is the first report on the epidemiology of depressive disorders from the European Outcome of Depression International Network (ODIN) study.Aims: To assess the prevalence of depressive disorders in randomly selected samples of the general population in five European countries.Method: The study was designed as a cross-sectional two-phase community study using the Beck Depression inventory during Phase 1, and the Schedule for Clinical Assessment in Neuropsychiatry during Phase 2.Results: An analysis of the combined sample (n=8.764) gave an overall prevalence of depressive disorders of 8.56% (95% CI 7.05-10.37). The figures were 10.05% (95% CI 7.80-12.85) for women and 6.61% (95% CI 4.92-8.83) for men. The centres fall into three categories: high prevalence (urban Ireland and urban UK), low prevalence (urban Spain) and medium prevalence (the remaining sites).Conclusions: Depressive disorder is a highly prevalent condition in Europe. The major finding is the wide difference in the prevalence of depressive disorders found across the study sites. [ABSTRACT FROM AUTHOR]

Background: There are no published reports of cross-cultural equivalence and interrater reliability at the level of individual symptom items assessed by a semi-structured clinical interview employing operationalised clinician ratings.Aims: To assess the cross-cultural clinical equivalence and reliability of a Chinese version of the World Health Organization Schedules for Clinical Assessment in Neuropsychiatry (SCAN).Method: UK-US and Taiwanese groups of psychiatrists used Chinese and English transcripts of videotape interviews of Taiwanese patients to discuss cross-cultural issues and ratings of SCAN items. Item ratings were compared quantitatively individually and pooled by SCAN section.Results: Chinese equivalents were found for all SCAN items. No between-group differences were found for most individual items, but there were differences for some scaled items. Average agreement between the two groups was 69-100%.Conclusions: Cross-cultural implementation based on SCAN in Taiwan appears valid. [ABSTRACT FROM AUTHOR]

Background Alzheimers disease manifests considerable heterogeneity, the cause of which is unknown. Aims To determine the familial (genotypic) influence on phenomenology (phenotype) in Alzheimer's disease. Method Affected sibling pairs with Alzheimers disease were assessed for a range of cognitive and non-cognitive symptoms. Resemblance for phenotypic characteristics was estimated using intraclass correlations for continuous traits and by pairwise concordance for dichotomous traits. The relationship between age of onset and APOE genotype was examined using linear regression analysis. Results Significant familial effects on age of onset (intraclass correlation 0.41) and mood state (intraclass correlation 0.26), and a relatively high pairwise concordance for agitation (excess concordance 0.1) were found. The APOE locus was found to account for 4% of the variance in age of onset. Conclusions Substantial familial influence on age of onset. depression and agitation suggests that genotype does influence phenotype in Alzheimer's disease. Establishing the molecular basis for this phenotypic variation may prove relevant to other neuropsychiatric disorders. [ABSTRACT FROM AUTHOR]

Mood instability is common, and an important feature of several psychiatric disorders. We discuss the definition and measurement of mood instability, and review its prevalence, characteristics, neurobiological correlates and clinical implications. We suggest that mood instability has underappreciated transdiagnostic potential as an investigational and therapeutic target. [ABSTRACT FROM AUTHOR]

Background: Hospital-based studies suggest that depression in old age relates to organic brain changes.Aims: To determine whether these findings are confirmed in a population-based sample.Method: A population sample of non-demented 85-year-olds (227 mentally healthy and 62 with DSM-III-R depression were given a neuropsychiatric examination and computerised tomographic scans of the brain, and followed for three years.Results: On the Mini-Mental State Examination, those with a low educational level with major depression performed worse than the mentally healthy; this distinction was not evident among those who had received higher education. Measures of brain atrophy were similar in depressed and mentally healthy individuals. The three-year incidence of dementia was increased in those with early-onset major depression.Conclusions: Higher education may protect against cognitive symptoms in depressed individuals. The association between depression and cerebral atrophy in the elderly is not very strong. The higher incidence of dementia in those with early-onset major depression may be due to a longer lifetime duration of depression, emphasising the importance of detecting and treating depression in the community. [ABSTRACT FROM AUTHOR]

Background: The objective is to estimate parameters of the natural history of panic disorder, including its prodrome, incidence, recovery and recurrence.Method: In 1981 the Baltimore Epidemiologic Catchment Area Study interviewed 3481 individuals probabilistically selected from the household population. During 1993-1996, 1920 of these individuals (73% of survivors) were interviewed again. Baseline and follow-up interviews included the National Institute of Mental Health Diagnostic Interview Schedule. During the follow-up, a subsample was assessed by psychiatrists using the World Health Organization Schedules for Clinical Assessment in Neuropsychiatry (SCAN).Results: There were 35 new cases of panic disorder in 24,475 person years of exposure, yielding an annual incidence of 1.43 per 1000 per year. Data from the SCAN assessments suggest the incidence estimate is conservative. Incidence is greater in females and declines with age. About one-third of the new cases arise without agoraphobia, but about half have anxiety of some sort present for many years prior to meeting criteria for diagnosis. People with agoraphobia have less intense onsets but slower recoveries than those without agoraphobia.Conclusions: Panic is heterogeneous in its pattern of onset and recovery. Some of the heterogeneity is associated with the presence of other anxiety over a long period of the life. [ABSTRACT FROM AUTHOR]

Background: For many common medical and neuropsychiatric disorders, early age at onset reflects high familial liability to illness. However, for schizophrenia, most studies do not find such a relationship.Method: Using Cox proportional hazard modes, we investigate this question in the epidemiologically-based Roscommon family study.Results: No relationship was found between age at onset in schizophrenic probands and the hazard rate for schizophrenia in their relatives. Similar results were obtained when the definition of illness was expanded to include schizoaffective disorder and other non-affective psychoses.Conclusions: For schizophrenia, a 'common-sense' model for age of onset (i.e. those with highest familial liability to illness succumb first while those with lower liability survive longer before falling ill) does not seem to apply. Our results are more consistent with a model in which variation in age at onset of schizophrenia is due to random developmental effects or to environmental experiences unique to the individual. [ABSTRACT FROM AUTHOR]

Background: This is the first attempt to study the prevalence and clinical characteristics of somatisation (ST) in a representative primary care sample in Spain.Method: The sample consisted of 1559 consecutive patients attending eight randomly selected health centres in Zaragoza, Spain, examined by two-phase screening. First phase (lay interviewers): Spanish versions of GHQ-28, CAGE questionnaire, substance abuse, Mini-Mental State Examination. Second phase (research clinicians and psychiatrists): Standardised Polyvalent Psychiatric Interview, which permits the reliable coding of Bridges & Goldberg's ST criteria.Results: The prevalence of somatisers was 9.4% (34.5% of the cases) and most patients (68.7%) were diagnosed in the depression or anxiety DSM-IV categories. The severity was moderate in 401% and 66.6% were chronic (six or more months). No significant demographic differences were found with non-cases. Backache was the most frequent somatic presentation (71.4+%).Conclusions: ST in primary care is a much broader phenomenon than categories such as somatoform disorders reflect. It may be less influenced by sociodemographic factors, but more chronic than previously reported. [ABSTRACT FROM AUTHOR]

Background: There is a need for a valid self-rating questionnaire to screen for psychiatric morbidity in patients with chronic fatigue syndrome (CFS). This study had the aim of assessing the utility and validity of two commonly used measures.Method: Scores obtained on the General Health Questionnaire (GHQ) and the Beck Depression Inventory (BDI) were compared with various diagnostic and severity ratings obtained via a validating clinical interview, the Schedules for the Clinical Assessment of Neuropsychiatry (SCAN) in 95 consecutively referred subjects at a medical out-patient clinic who fulfilled standard criteria for CFS, and 48 healthy controls. Outcome measures were validating coefficients and receiver operating characteristics (ROC) for different thresholds and scoring on GHQ and BDI and index of definition (ID) as measured by SCAN; and Pearson and point by serial correlation coefficients for different diagnostic groups derived via SCAN and defined according to ICD-10 and DSM-III-R.Results: GHQ and BDI perform poorly as screeners of psychiatric morbidity in CFS subjects when compared with various SCAN derived ratings although results for controls are comparable with other studies.Conclusions: Neither the GHQ nor BDI alone can be recommended as screeners for psychiatric morbidity in CFS subjects. [ABSTRACT FROM AUTHOR]

The article argues that psychiatrists should consider using a cognitive nosology based on a modern understanding of human psychological architecture towards the aim of establishing the new discipline of cognitive neuropsychiatry. It is also recommended that psychiatrists classify their patients in terms of lesions to information processing systems.

Background: The effectiveness of different assessment procedures for determining prevalence rates of psychiatric disorder in young adults was investigated.Method: In a two-stage multi-method procedure, the Young Adult Self-Report, the Schedules for Clinical Assessment in Neuropsychiatry (SCAN), the Structured Interview for Personality Disorders (Revised), and the Global Assessment of Functioning (GAF) Scale were used to assess prevalence rates in 706 19-24-year-olds from the general population. Furthermore, individuals' subjective perception of distress and referral to mental health services were assessed.Results: The prevalence of any SCAN/DSM-III-R disorder was 19.3% (95% confidence interval: 11.2-27.4%). Most subjects who received a SCAN/DSM-III-R diagnosis were only mildly impaired. The highest prevalence rates of dysfunctioning (GAF score below 61) without referral to mental health services were for dissociative disorder (2.3%), sleep disorder (2.1%), alcohol dependence (1.3%) and affective disorder (1.8%).Conclusion: Instruments that assess functional impairment in addition to DSM-III-R diagnoses are indispensable in prevalence studies. [ABSTRACT FROM AUTHOR]

The article focuses on linguistics and its applications to psychiatry. It notes that for linguistics to be significant in a psychiatric context, there should be an analysis of the grammatical or propositional context. It is also necessary to establish the act accomplished by an utterance, the relevance of the discourse and the resulting social interaction between speaker and listener.

A historical review of Kahlbaum's Catatonia is presented. He attributed the condition to organic cerebral disease. It is now best considered as a neuropsychiatric syndrome due to a wide variety of organic disease processes, manifest in catelepsy in a setting of an abnormal mental state, most commonly an affective disorder. Chronic catatonic states were common sequelae of encephalitis lethargica; this disease has now disappeared in epidemic form with a resulting fall in the incidence of catatonia in psychiatric hospitals. Acute catatonia, due to medical and particularly pharmacogenic causes, continues to occur in current psychiatric practice. [ABSTRACT FROM AUTHOR]

To examine the neuropsychiatric effects of infection with HIV, 220 drug users (27 HIV negative, 193 HIV positive) completed tests evaluating premorbid intelligence, memory, non-verbal performance, information processing speed, and mood. When these measures were compared cross-sectionally by the severity of HIV illness, symptomatic patients (in CDC stage IV) were impaired on Trails B, two-choice decision time, delayed recall of the Wechsler Logical Memory Test and most components of the Auditory Verbal Learning Test. These findings imply reduced capacity for concentration, speed of thought and memory. When 101 patients were retested a mean of 16 months after their initial assessment, performance on Trails A and B, Block Design and delayed recall of the Wechsler Logical Memory Test deteriorated more for patients at, or progressing within, CDC stage IV, than performance of patients at stage III. The results broadly correspond to the cross-sectional findings. However, there was a decline in all tests of memory function for the sample independent of clinical staging. This may be evidence of brain involvement before the appearance of other symptoms. Self-rated measures of mood did not change cross-sectionally, progressively, or interactively with time and stage of HIV illness, and cannot account for the changes in cognitive function observed. Change in drug use, similarly, does not account for the cognitive findings. Four (5%) of the retested subjects developed AIDS dementia complex, but most of the performance and memory impairments seen were subclinical despite the destructive neuropathology presumed to underlie intellectual decline in patients with HIV infection.(ABSTRACT TRUNCATED AT 250 WORDS) [ABSTRACT FROM AUTHOR]

The article focuses on a study about positron emission tomography (PET) in brain metabolism in psychiatric and neuropsychiatric disorders. The feasibility of PET is dependent upon the availability of compounds that can be labeled with positron-emitting nuclides. The data acquired in a PET study is understood and expressed in terms of some physiological, biochemical or pharmacological process. The study concludes that PET is the most powerful technique available for the investigation of brain function in vivo. It states that majority of studies of patients with psychiatric disorders have been in the resting state. The authors suggest that future PET programs should lead to advances in understanding of the pathophysiology of major psychoses.

The article presents information on the technique of Magnetic Resonance Imaging (MRI) and its applications in neuropsychiatry. The method of MRI involves the alignment of protons in the direction of a static magnetic field in which they are placed, due to which a magnetic moment is produced which is measured with the help of a radiofrequency impulse administered in the magnetic field. The MRI is found to be useful in the study of neurological diseases like multiple sclerosis and cerebral infarction as it can detect lesions and brain atrophy and any change in the dimension of brain areas.

Gull and Lasègue are usually credited with the first description of anorexia nervosa. In general, however, the work of the French neuropsychiatrist has been underestimated, and English-speaking colleagues who refer to Lasègue's writing on 'hysterical anorexia' almost exclusively rely on the translation of his French paper, which in 1873 appeared in a British medical journal, the same year as the original publication. However, some important passages had been omitted from the translation, and this has not previously been noted. [ABSTRACT FROM AUTHOR]

In the 19th century the triumphs of neuropathology and the clinico-anatomical method led to the evolution of neurology as a separate 'organically' based discipline associated with the concept of functional localisation. At the same time the growth of psychodynamic psychiatry contributed to the progressive separation of the two disciplines, with neuropsychiatry sitting uneasily in the middle. Psychiatrists are now showing increasing interest in the structure and function of the nervous system, but are having difficulty in integrating their findings into 'functional' diseases. This may be because disorder of function in the nervous system is much more complex than previously envisaged. The function of the nervous system is profoundly affected by psychological and social factors. The view that neurology is wholly 'organic' and synonymous with structural disease of the nervous system is fallacious. Neurological patients have complex dynamic disorders of function in the nervous system whether or not structural disease is present. [ABSTRACT FROM AUTHOR]

The article characterizes organic psychiatry. According to the article, organic psychiatry is the cognitive, behavioral and emotional consequences of cerebral disorder and is different from neuropsychiatry. The author states that organic psychiatry has benefited from technological developments in neurosciences, particularly in its use of brain imaging and molecular genetics. Despite these developments, the author states that conceptual issues, such as organic or psychological causation of psychopathology, have remained traditional in status.

The article comments on the principal areas of concern for mental health professionals, namely the stigmatization, psychological problems and psychiatric and neuropsychiatric disorders which result from infection with HIV. The author notes that dementia, delirium and many of the more psychotic presentations occur with more profound immunosuppression and their management will demand close link between medical and psychiatric teams. The author adds that psychological research should continue to delineate both predisposing and protective social and psychological factors for psychiatric disorder among sufferers in varying communities and countries.

Recent clinical studies have identified significant olfactory deficits in several neuropsychiatric disorders, notably Alzheimer's disease and Parkinson's disease. These have correlated with neurochemical and neuropathological studies of the olfactory system. The presence of a specific sensory deficit may be related to the localisation of pathology within the brain. There is a need for incorporation of olfactory testing into routine clinical examination. [ABSTRACT FROM AUTHOR]

The Capgras delusion has long been held to be specific for close personal relationships. This paper presents evidence that this is not the case and the implications of this for accepting psychodynamic explanations of the phenomenon are discussed. Parallels are drawn with the condition prosopagnosia and a hypothesis presented that any specificity is apparent rather than real. It is proposed that both prosopagnosia and the Capgras symptom represent abnormalities of visual perception occurring at different stages of this neurophysiological process. [ABSTRACT FROM AUTHOR]

HIV disease often leads to neuropsychiatric disturbance, either through direct infection of the brain by the virus or through CNS disease secondary to immunodeficiency. Neuropsychiatric complications of AIDS and AIDS-related disorders may present clinically as acute or chronic organic mental syndromes, or may mimic functional psychiatric illness, in particular depression, anxiety, or psychotic states. Two cases of hypomanic states in homosexual men suffering from AIDS are reported. Neither of the two men had a personal or family history of affective disorder. In one man, hypomanic symptoms were caused by early HIV encephalopathy; he rapidly developed typical HIV dementia with a marked downhill course. In the second case, a clear connection between the hypomanic symptoms and direct HIV brain involvement was not established. [ABSTRACT FROM AUTHOR]

Three groups of neuropsychiatric out-patients, homogeneous according to parameters of violent behaviour, were identified in a previous study using a cluster analysis procedure and compared in this study on psychometric variables. These groups were (a) a group manifesting frequent, impulsive violence (n = 35), (b) a non-violent group (n = 57), and (c) a group whose violent behaviour was much less frequent and severe than in the first group, and more provoked (n = 31). Impulsively violent patients showed language and visual-perceptual deficits, but no other neuropsychological or intellectual deficits. The MMPI F, K and Ma and MacAndrews Alcoholism scales and a perceptual organisation factor derived from the Holtzman Inkblot Test significantly discriminated groups. Results of this and the initial study have implications regarding psychological aspects of aggression and underlying biological mechanisms. [ABSTRACT FROM AUTHOR]

The publication of DSM-III introduced the diagnosis Post-Traumatic Stress Disorder (PTSD), thus providing, for the first time, a framework for studying the consequences of extremely stressful events. Previously, traumatic neuroses had attracted a wide variety of labels — as wide as the experiences that produced them. Competing explanations in psychological and biological terms have characterised the approach to these disorders, and social and legal issues have added to the confusion. In recent years, psychosocial issues have tended to dominate the literature in relation to PTSD. While acknowledging the importance of such phenomenological and psychosocial approaches, this paper seeks to redress the balance by focusing on a biological perspective. [ABSTRACT FROM AUTHOR]

A new interview schedule for the diagnosis and measurement of dementia in the elderly is described. The schedule named the Cambridge Mental Disorders of the Elderly Examination (CAMDEX), consists of three main sections: (1) A structured clinical interview with the patient to obtain systematic information about the present state, past history and family history; (2) a range of objective cognitive tests which constitute a mini-neuropsychological battery; (3) a structured interview with a relative or other informant to obtain independent information about the respondent's present state, past history and family history. The CAMDEX is acceptable to patients, has a high inter-rater reliability and the cognitive section has been shown to have high sensitivity and specificity. [ABSTRACT FROM AUTHOR]

Subcortical dementia refers to a clinical syndrome characterised by slowing of cognition, memory disturbances, difficulty with complex intellectual tasks such as strategy generation and problem solving, visuospatial abnormalities, and disturbances of mood and affect. The syndrome was first described by Kinnier Wilson, but further progress in development of the concept has occurred only within the past ten years. Subcortical dementia occurs in degenerative extrapyramidal disorders and has also been identified in inflammatory, infectious, and vascular conditions. Histologic, metabolic, and neurochemical investigations implicate dysfunction primarily of subcortical neurotransmitter systems and subcortical structures or subcortical-frontal connections in the genesis of the syndrome. Subcortical dementia contrasts neuropsychologically and anatomically with disorders such as dementia of the Alzheimer type that affect primarily the cerebral cortex. The clinical characteristics of subcortical dementia reflect the interruption of fundamental functions (motivation, mood, timing, arousal) mediated by phylogenetically and ontogenetically early maturing structures. [ABSTRACT FROM AUTHOR]

We review the English-language literature on Asperger's syndrome (AS), with particular reference to diagnostic criteria and differentiation from infantile autism and personality disorders, and describe six cases seen in practice: all met DSM-III criteria for 'atypical pervasive developmental disorder'. Three also developed Tourette syndrome: the co-occurrence of the two disorders, and methods of intervention, are discussed. [ABSTRACT FROM AUTHOR]

Organic delusions are common, but have received little systematic study. Review of the literature reveals that they occur most commonly in toxic-metabolic processes and in disorders affecting the limbic system and basal ganglia. A prospective study of 20 consecutive patients with organic delusions revealed four general types of false beliefs: simple persecutory delusions, complex persecutory delusions, grandiose delusions, and those associated with specific neurological defects (anosognosia, reduplicative paramnesia). Simple delusions responded best to treatment, and complex delusions were more resistent. Acting on delusional beliefs was not unusual, and treatment of the delusions was an important aspect of management of the patient. [ABSTRACT FROM AUTHOR]

Subjects in Botswana were asked to state their preference between modern (doctor or nurse) or indigenous (traditional or religious healer) care for three case vignettes of epilepsy, psychosis, and tuberculosis. Nurses, medical patients, and a general village population were studied. Many subjects preferred modern care for all disorders, whilst a small number favoured indigenous treatment only. A significant percentage discriminated between disorders, choosing indigenous care for some and modern for others. Indigenous care was most favoured for epilepsy, and least for tuberculosis. Psychosis took an intermediate position. The size of the discriminating group varied between populations, but the overall pattern of attitudes remained the same. Neither demographic factors nor aetiological beliefs consistently identified those who choose indigenous care. [ABSTRACT FROM AUTHOR]

The article focuses on trace metals in neuropsychiatry. Some trace amount metals in the body, including vanadium and copper, were found to have an influence in the severity of manic-depressive illnesses and other affective disorders. The author believes that there may also be a future for complexed metals in psychopharmacology and one may also speculate that drugs may be developed which can complex a metal in situ within the cell and withdraw it from an enzyme and give a specific switch to some metabolic process.

The article focuses on the different aspects of bilingualism which are directly associated to the diagnosis and treatment of neuropsychiatric disorders. According to the author, the bilingual patient in Great Britain is divided into three categories including native English speakers who have learned fluency in a foreign language, immigrants from non-English speaking cultures who have learned English as a second language and native individuals raised in a bilingual environment. It is stated that the most common clinical aspect of bilingualism reported in several neuro-pathological conditions involve aphasia or differential language loss which is the most commonly observed succeeding cerebrovascular diseases in older people.

A prospective follow-up study of 60 randomly selected cases of closed adult civilian head injuries was conducted for three months from the time of head injury to assess the frequency, patterns, and factors related to post-traumatic psychiatric disturbances. Eighty per cent of the cases had a neuropsychiatric disturbance as assessed at 1 1/2 months. The commonest was post-concussional syndrome (43 per cent). The extent of social dysfunction was directly related to the severity of head injury. However, the total number of symptoms (largely subjective) correlated highly with pre-traumatic neuroticism. The inter-relatedness of organic and personality factors in the post-traumatic syndrome, and their predictive value, are discussed. [ABSTRACT FROM AUTHOR]

This paper extends the recent work of Hall (1974) by presenting the minimal sample sizes and the specific linear agreement weights required for assessing the reliability of rating scales commonly used in neuropsychiatric and other clinico-medical settings. The weights are shown to vary as a function of (a) whether or not the rating scale contains a point of 'absence', and (b) the number of ordinal points on the scale. [ABSTRACT FROM AUTHOR]

The article presents a case report of Korsakoff's syndrome as a neuropsychiatric sequelae of attempted hanging. Strangulation has been cited as the cause of Korsakoff's syndrome in all surveys of the numerous causes of the disorder. The patient is a 39-year-old merchant seaman, who was found hanging in the ward lavatory of the ship. Oxygen and external cardiac massage were administered and the pulse and color were restored. He had no family history of psychiatric illness. The possibility of a hysterical pseudodementia was raised immediately after the attempt of suicide. The researchers concluded that intellectual defects in the Korsakoff's syndrome do not invalidate a diagnosis of the syndrome if other symptoms are present.

The article cites a study that primarily concerns with the aetiology of the acute tremulous and hallucinatory states complicating chronic alcoholism. Subjects of the study consist of seventeen chronic alcoholics. Clinical and metabolic findings during the week after alcohol withdrawal of the subjects are described. Typical delirium tremens occurred in three of the eight patients of group A who developed hallucinatory states. Nine patients of group B did not develop such psychiatric complications. Moreover, results of the study suggest that alcohol withdrawal alone may precipitate delirium tremens, and thiamine deficiency may itself lead to subacute hallucinatory states in habituated individuals.

The article presents several medical cases of sex chromatin negative women who are said to suffer neuropsychiatric disorders. The first case is about a woman who was sent to a mental hospital because she was starting to show signs like growing nervous and getting sudden attacks of laughing or weeping. The second case is about a woman who was treated for psychosis at a mental hospital because she was allegedly seeing Satan and hearing voices which try to stop her talks with God. The third case is about a woman who was allegedly admitted to a psychiatric department in connection with an application for a disablement pension. The fourth case, on the other hand, is about a woman who was treated for anorexia nervosa. These cases, accordingly, show the different kinds of gonosomal aneuploidy.

The article discusses the study regarding the lineage of Walbiri people in central Australia, to determine the evolution in the neuropsychiatric illness pattern. It investigates the nature of this evolution taking place during the rapid acculturation of Australian Aborigines. It presents the mental illness data of a Walbiri lineage and discusses some complexities of the situation. Thus, it shows that an evolution of illness patterns is taking place, due to evidence collected in the field, in the Walbiri territories and Aranda tribes, and in the companion papers. However, further fieldwork is considered necessary to determine how fundamental this evolution may be.